RESUMO
Digital health applications (apps) have the potential to improve health behaviors and outcomes. We aimed to examine the effectiveness of a consumer web-based app linked to primary care electronic health records (EHRs). CONNECT was a multicenter randomized controlled trial involving patients with or at risk of cardiovascular disease (CVD) recruited from primary care (Clinical Trial registration ACTRN12613000715774). Intervention participants received an interactive app which was pre-populated and refreshed with EHR risk factor data, diagnoses and, medications. Interactive risk calculators, motivational messages and lifestyle goal tracking were also included. Control group received usual health care. Primary outcome was adherence to guideline-recommended medications (≥80% of days covered for blood pressure (BP) and statin medications). Secondary outcomes included attainment of risk factor targets and eHealth literacy. In total, 934 patients were recruited; mean age 67.6 (±8.1) years. At 12 months, the proportion with >80% days covered with recommended medicines was low overall and there was no difference between the groups (32.8% vs. 29.9%; relative risk [RR] 1.07 [95% CI, 0.88-1.20] p = 0.49). There was borderline improvement in the proportion meeting BP and LDL targets in intervention vs. control (17.1% vs. 12.1% RR 1.40 [95% CI, 0.97-2.03] p = 0.07). The intervention was associated with increased attainment of physical activity targets (87.0% intervention vs. 79.7% control, p = 0.02) and e-health literacy scores (72.6% intervention vs. 64.0% control, p = 0.02). In conclusion, a consumer app integrated with primary health care EHRs was not effective in increasing medication adherence. Borderline improvements in risk factors and modest behavior changes were observed.
RESUMO
BACKGROUND: The Internet is a valuable information tool, but users often struggle to locate good quality information from within the vast amount of information available. OBJECTIVE: The aim of the study was to identify the online information resources available to assist students develop Internet searching skills, and to explore the students' priorities in online guides. METHODS: A qualitative approach was adopted with two phases. The first was a structured search of available online study skills resources. The second comprised 10 group interviews with a total of 60 students at all stages of five undergraduate health and social care related courses at a UK university. RESULTS: The study found that there were good online guides available, but that, perversely, the better guides tended to require the best searching skills to locate them. A few students were enthusiastic about using online support, however the majority felt that if they had the skills to locate such resources they wouldn't use a study guide to improve these skills, and if they did not have the skills they would not think of using an online guide to develop them. CONCLUSIONS: Students wanted assistance when they had problems or questions, rather than sites that offered structured learning experiences. Personal support rather than virtual support was also considered to be most important to the students in this study.